Individual
MAGDALENE VIDAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
177 30 WEXFORD TERRACE, SUITE A, JAMAICA, NY 11432
(347) 494-4896
(347) 494-4592
Mailing address
17730 WEXFORD TER, JAMAICA, NY 11432-2924
(347) 494-4896
(347) 494-4592
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/17/2019
Last updated
06/17/2019
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